The effectiveness of methadone-assisted rehabilitation in reducing heroin use and improving productive behavior was demonstrated during the 1960s and 1970s. Its effectiveness in the 1980s, however, has been called into question and corresponds with declines in the availability of vocational services and the extent to which programs are meeting Federal mandates to provide them. Although many methadone clients do work, others who want to become productive members of the labor force are often unable to do so because of deficits in both the community and the client. Vocational and educational services also appear to reduce cocaine use by offering clients something productive to do. This application is to compare the effectiveness of two levels of increased vocational services in a randomly controlled trial with 1,280 clients in four methadone treatment programs in Buffalo, NY, Milwaukee, WI, Pittsburgh PA, and San Jose, CA. The first level will include a standardized needs assessment, a community resource directory, and counselor training. The second level will include these items as well as motivational/job seeker's workshops, additional financial resources to address gaps in the service system, and the assistance of an on-site vocational researcher. The proposed study will also construct 1- to 2-year baseline control groups at each site using data collected under two earlier National Institute on Drug Abuse (NIDA) grants. This includes a pilot test of the proposed vocational service protocol and instruments. The study will draw on instrumentation currently being used in other national studies including DATOS, and MTQAS. It will also use computer software developed under the DC Initiative to produce client needs assessment profiles. The proposed study is designed to meet pressing national and local concerns about access to treatment, effective rehabilitation, and reducing the spread of infectious diseases such as the acquired immunodeficiency syndrome (AIDS). The proposed research will build on a promising new approach to vocational services and allow a definitive and rigorous evaluation that will be directly comparable with several other major studies of other treatment programs. By using a pilot-tested protocol and continuing an existing consortium with four community-based programs, the proposed effort can be fully implemented within 1 to 2 months of award.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Drug Abuse Epidemiology and Prevention Research Review Committee (DAPA)
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Research Triangle Institute
Research Triangle Park
United States
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Karuntzos, G T; Caddell, J M; Dennis, M L (1994) Gender differences in vocational needs and outcomes for methadone treatment clients. J Psychoactive Drugs 26:173-80